Feedback Form Template Feedback

So repl.it is hosting a template jam, and I decided to post a feedback form in Python where you automatically get the filled in responses in your email, and it also has a cooldown for each device (so nobody can spam it).

Here is the link for the template:
https://replit.com/@VulcanWM/feedback-form#README.md

How much would you rate this from 1-10? Does it have any chance of winning?
How can I improve the template?
Do you have any other template ideas?